Treat your pain and live a better life…

best-pain-doctor-nycWelcome to my blog about pain. Unfortunately, many people suffer from chronic pain. As a board certified physician in physical medicine and rehabilitation, my specialty is treating these people with both acute and chronic pain.

A majority of my practice is working with patients that are experiencing back and neck pain.

My goal with this blog is to help patients who are experiencing any type of back or neck pain to understand what is causing their pain and discuss options that are available to end their pain. I hope to be able to provide readers with a portal that they can can use to educate themselves and facilitate treatment.

My specialty is my Interventional Spine Skills including cervical and lumbar epidural steroid injections, facet injections, medial branch blocks, Radiofrequency ablation, sympathetic ganglion blocks, spinal cord stimulator trials, sacroiliac joint injection, piriformis muscle block and musculoskeletal joint injection. I also perform many other procedures to alleviate acute and chronic pain.

I hope you enjoy reading my blog as much as I enjoy writing it and observing people from all over the world reading it.

– Matthew Grimm, M.D.

Category Archives: Injections for Pain

Caudal Injections for Pain Management

Caudal injections are best for curing lower back pain and leg pain, usually caused by sciatica, spinal stenosis, spondylosis, and other back-related issues. The doctor administers this injection into your lower back, into the space between the membrane. This membrane consists of the spinal fluid and the strongest ligament between your vertebrae. If you‘re suffering from unbearable back or leg pain, your doctor will most likely prescribe you this injection. If you want to learn more about caudal injection and its effectiveness, you must read further.

Caudal Injections for Pain Management
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What is a Caudal Injection?

A caudal injection is a type of steroid injection that gets administered in the lowest area of your epidural space. This injection helps reduce lower back pain as well as leg pain caused by major back problems like sciatica, bone spurs, herniated discs, stenosis, and other related problems. The pain occurs when the nerve roots, running from your spinal cord to your back and legs, get inflamed, which could be due to a damaged disc or another condition. The only way to reduce this terrible pain is by getting a caudal injection as it helps saturate the inflammation.

The Caudal Injection Process

The process of administering a caudal injection is pretty simple, but it is painful to a certain extent. A pain management specialist injects the caudal shot in the affected area to relieve the patient of the pain and discomfort. It takes around 15 minutes, depending on the expertise of the doctor. For the injection, you will have to lie straight on an x-ray table on your abdomen. Next, the doctor will give you some intravenous medication and numb the skin on your lower back with a local anesthetic.

After this, the doctor will administer a thin needle into your lower back, above your tail bone. Next, the specialist will inject the dye and a mixture of anesthetic or steroids for pain relief. As soon as you get the injection, the medicines will then spread into the caudal and epidural spaces, which will give you some relief from the pain.

Caudal Injections
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Effectiveness of Caudal Injection

Caudal injections are quite effective, especially when it comes to getting rid of severe back pain. Many people wonder how long and effective the injection is. It starts to work within 30 minutes after you get the dose. However, you might start to experience some pain again as the local anesthetic starts to wear off after a few hours.

You will begin to experience longer-term relief in two to three days when the steroid starts working. The time limit differs from person to person. For some people, the relief lasts longer than usual. If the injection helps relieve your pain, you can get the shots periodically to stay away from pain.

Potential benefits of caudal injections:

  • Instant back or leg pain relief
  • Fast recovery
  • Fewer risks involved
  • Can go home within 30mins after the injections

Potential Risks Involved

There are a few risks involved when you get the caudal injections. These risks are usually explained to you by your doctor before going in for the procedure. However, they do not last long in most cases, and your pain management doctor will help you deal with these side-effects:

  • Bleeding
  • Chance of the back area getting infected (rarely)
  • Numbness
  • May experience excessive pain
  • Headaches
  • Insomnia
  • Drowsiness
  • Nerve problems
  • Stroke
  • Spinal Cord Injury

How to Prepare For Your Caudal Injection

Whenever you plan on getting a caudal injection, you must prepare yourself mentally and physically and keep all the required information ready. There are a few things you can do to stay fully prepared for your injection.

First, when you visit your doctor, he/she will take your medical history. So keep a list of all the medications you are taking and X-ray reports of your CT scan, MRI, and any other tests you have undergone for the diagnosis and treatment of your pain.

It is best to avoid taking any medications before the process, especially if the injection is for diagnosis. This way, you can tell if the injection has worked or not. You may have to fast a few hours before your injection, but you must confirm this with your doctor.

When going for your injection, make sure to wear the comfiest clothes in your closet. Don’t wear anything tight that would stick to your body, especially the area where you’re getting the injection on.

If you feel sick or are suffering from mild flu or fever the day before your procedure, you must inform your doctor as they will guide you as to whether you should get the injection the same day or after you feel better.

Conclusion

If you’re struggling with severe back pain and feel like you may need a caudal injection to relieve the symptoms,  consult Dr. Matthew Grimm. He is one of the best pain management doctors in NYC and knows how to treat all types of pain. It is best not to delay the treatment as it may lead to other issues.

Visit our website or call us at 646-862-5555 to book an in person or telemedicine appointment today!

Do You Need Joint Injections For Your Pain?

Do You Need Joint Injections For Your Pain? If you have joint pain, you will agree that the pain is sometimes unbearable. Such pain can make your chores impossible and you might not feel active throughout the day. Your doctor can treat you without pills and surgeries. Injections can also be an option if you are suffering from joint pain.

Injections can help reduce pain and inflammation. You can experience fewer symptoms for months with the help of these treatments. There are several options for injectables that can help manage or eliminate your joint pain. These options are:

  • Corticosteroid Injections
  • Hyaluronic Acid (HA) Injections
  • Platelet-Rich Plasma (PRP) and Stem Cell Therapy Injections
  • Placental Tissue Matrix (PTM) Injections

Do You Need Joint Injections for Pain 01

1.     Corticosteroid Injections

These types of injections are commonly known as Steroid injections. These injections can treat a variety of conditions and are anti-inflammatory. Corticosteroid injections are the first option for defense against osteoarthritis symptoms. These injections can reduce the pain for about 2 to 3 months. They can provide you relief and reduce inflammatory cells. Another benefit of steroid injection is reducing the activity of the immune system. Injecting these injections allows doctors to deliver a high dose of medications into the affected area directly. Other than knees, doctors can also give these injections in the following areas:

  • Hip Joint
  • Shoulder, hand, and elbow
  • Sacroiliac joint
  • Facet joints of the spine
  • Ankle and foot

2.     Hyaluronic Acid (HA) Injections

Do You Need Joint Injections for Chronic Pain 02When Corticosteroid does not work, doctors inject Hyaluronic Acid injections. If the lubricant between the joint is missing, an HA injection can help replace it. Food and Drug Administration (FDA) approve these for use in the knees but some doctors use these for shoulders and hips too. These injections help provide relief from pain and stiffness.

You get this injection like you get other ordinary injections. After cleaning the area, the doctor may inject a local painkiller if you have knee swollen with access fluid. After that, the doctor will withdraw any access fluid by inserting the needle. Then the doctor inserts hyaluronic acid into the knee joint by keeping the same needle in place. HA treatment has shown great effects in experiments and studies;, anti-inflammatory, analgesic, intra-articular lubrication, and chondroprotective effects are some examples. You can find below some advantages of hyaluronic acid:

  • Your skin will look more supple and healthier.
  • It hydrates the skin and reduces the appearance of wrinkles.
  • It plays a great role in healing wounds.
  • It keeps the joints between your bones lubricated.
  • It is a great pain reliever.

3.     Platelet-Rich Plasma (PRP) Injections

PRP Injections can also treat joint pain. To promote healing these injections use your blood and platelets. Platelets contain proteins that can help in healing soft tissues. They can help alter the immune system to reduce inflammation. PRP has also been useful in promoting cell regeneration. Some advantages of Platelet-Rich Plasma injections are:

  • This plasma comes from the patient’s body and contains lesser risks.
  • These are natural and autologous fluids.
  • There is no use of pharmaceutical chemicals, plumping agents and strong acids in this treatment.
  • Treatment with Platelet-Rich Plasma has long-lasting results.
  • It only takes a few minutes to complete.
  • It increases the production of collagen.

4.     Placental Tissue Matrix (PTM) Injections

Placental Tissue Matrix is useful for decreasing pain related to osteoarthritis. These injections contain placental tissue. These tissues, obtained after healthy baby delivery of a healthy mother, are helpful for knee pain. A number of growth factors in these tissues promote healing.

  • These tissues are safe and effective for the body.
  • These are easy to administer.
  • PTM tissues do not require extensive methods to obtain.
  • Not a really expensive method to reduce pain.
  • These are free of tissue rejection concerns. This happens because of amniotic cells immune-privileged status.

Conclusion

Joint injections can help you prevent pain for several months and substitute painful surgeries and pills. To know better how these injections can give you relief from joint pain, contact us.

Give us a call at 646-862-5555 or book an appointment with our Pain Management Doctor to get help with your condition.

What Are Injections for Pain?

Do you need injections for pain? The pain management procedure requires the insertion of injections with image guidance. These procedures help you in pain relief and the goal is to bring you back to normal life. Pain injections are a perfect option for those who have chronic neck and back pain but are afraid of surgeries. Injections can help find the source of pain and provide relief. With the help of injections, the doctor can administer medications directly into the affected location of pain and provide relief when ordinary medicines don’t work.

What are injections for pain?

When a steroid or pain reliever medication goes into the affected area, it numbs the pain and reduces inflammation. It also creates a heat lesion on the nerve that transmits pain and prevents it from sending signals of pain to the brain. Some of the injections that help in relieving pain and inflammation in various body parts are as follows:

Spinal Injections for Treating Pain

spinal injections for painThe use of spinal injection is to diagnose and treat low back pain. The goal of the diagnostic injection is to find if the medication provides relief to your pain. Diagnosis injections provide temporary relief, usually just for a few hours and injections for treatment can provide long-lasting relief. You can few common spinal injections below:

1.     Selective Nerve Root Block:

These are the most common spinal injections. Your doctor can give you this injection if a damaged nerve root is causing leg or back pain. A nerve root serves the complete body and is a collection of nerves. When the nerve root gets compressed and irritated, it may result in leg pain. The technical name of this condition is radiculopathy and most people call it sciatica.

2.     Lumbar Facet Joint Nerve Blocks:

If the doctor suspects that your pain is heading from the joints at the back of your spine, he or she will probably recommend you facet injection. The facet joint is commonly responsible for adding integrity to the spine by allowing excessive movement. These joints are present at each side on each vertebral level and are quite small.

Neck and Back Injections for Treating Pain

When neck or back pain does not go away, your doctor will recommend you exercise and physical therapy. If the pain remains, the doctor will include injections in your treatment to ease your back and neck pain and inflammation. These injections contain steroids or numbing medicines. Common injections that doctors use to give you relief are:

1.     Epidural Injections:

Doctors deposit this medication or typically steroids in the epidural space inside the spine. It provides temporary or lasting relief. To place the needle in the right place for a better treatment, doctors use imaging guidance. Your doctor may tell you not to eat or drink a few hours before getting the injection.

2.     Selective Nerve Root Block Injections:

When doctors have to treat a spinal nerve separately, these injections are their first option. Rather than releasing medication right onto the nerve, the injection covers the area around it. . It is a long-lasting steroid. These injections are a great help in reducing pain or inflammation resulting from pressure on the nerve.

3.     Medial Branch Blocks:

It helps deposit medication around the medial branches of the spinal cord. The medial branch sends a pain signal to the brain from an arthritic facet joint. It is a type of nerve. These medial branches help relieve neck or headaches stemming from the neck.

4.     Sacroiliac (SI) Joint Injections:

These injections primarily help in diagnose or treat low back pain. The sacroiliac joints connect the sacrum with the hip on both sides and are present next to the spine.

Knee Injections for Treating Pain

1.     Corticosteroid Injections:

These steroids are similar to cortisol, which is a hormone that your body naturally produces. It helps to reduce inflammation.  These injections are effective if injected directly in the knee.

2.     Hyaluronic Injections:

Hyaluronic acid helps to provide lubrication and coats your cartilage to reduce friction when knee joints move. If you are suffering from osteoarthritis, you might be missing this lubricating substance and feel pain and inflammation. This injection introduces hyaluronic acid directly into your knee and reduces pain.

Conclusion

If you are suffering from pain and inflammation, give a call at 646-862-5555 or book an appointment with our Pain Management Doctor. Our doctor, Dr. Mathew Grimm is an expert in treating all kinds of pain.

Sacroiliac Joint Injections

Our body comprises multiple joints; one of them is Sacroiliac (SI) joint. These joints connect the lower spine and pelvis. Our lower back has two sacroiliac joints present on both sides of the spine. When you walk or stand, these joints lift the weight of your upper body and shift the weight to your legs.

Does your job keep you on the move? Or if it requires you to stand for the whole day, you may have experienced pain in your lower back. Your butts may also hurt; this possibly happens because of sacroiliitis.

Sacroiliitis

 Where does it hurt?

You start feeling pain when inflammation of the SI joints takes place.  Initially, you may only feel pain the lower back or buttock region, but it may go down further. Sacroiliitis may cause your thighs, groin, hip, abdomen, or upper back to hurt.

What Causes SI Joint Pain?

You may feel a dull pain in the SI joints. However, the pain sharpens due to certain reasons. Let’s have a look at some of the causes of sacroiliitis.

  • If you are a fitness freak or a sports person, you are likely to begin your day with running or jogging. When the SI joints get regular pounding, you may experience pain.
  • Bumping into a motor vehicle, or falling may also damage the joints.
  • Taking long uneven strides may be troublesome.
  • When the ligaments holding the SI joints get damaged, you may experience pain with abnormal joint movement.
  • Inflammatory arthritis affecting the spine, called ankylosing spondylitis, may also damage the SI joint.
  • During pregnancy, a woman’s body releases hormones causing the joints to loosen up and stretch. The additional weight affects the SI joints and may lead to abnormal wear.

How to Relieve the Pain?

You may choose one of these ways to relieve sacroiliitis pain.

  • Physical therapy like massage, heat and cold treatments, or stretching
  • A chiropractor may adjust the joint movement
  • Damaging the nerve sending a pain signal to the SI joint
  • Sacroiliac Joint Injections

Sacroiliac Joint Injections

Studies have suggested that 10% to 27% chronic low back pain cases are a result of SI joint pain. Sacroiliac joint injections are more effective in reducing SI joint inflammation than other medications. The injection ensures months of comfort.

Pain management doctors use SI joint injection for both diagnosis and treatment of the pain. The doctor thoroughly examines the patient performing provocative tests. Three or more positive results of SI joint provocative tests confirm the joint to be the pain source. The doctor will numb the joint using anesthesia. If the pain instantly goes away, it confirms that the joint is the culprit.

To reduce the inflammation, the doctor then injects a shot of cortisone in the joint. The injection provides relief to the joint for a longer time. Sometimes the doctors also inject natural ingredients, like saline, in the joint to provide relief.

Sacroiliac Joint Injections are effective, but they can weaken joint bones. If you have sacroiliitis, only go for a few joint injections a year.

Bottom Line

If you want to live a pain-free healthy life, all your joints should work properly. If you are experiencing any spinal or musculoskeletal pain, don’t neglect it.

Contact us today and book an appointment with the best pain physicians at Spine New York City.

Injections for Pain

Neck and back pains can become a source of discomfort, interrupting your daily routine. You may face some serious trouble in small activities like sitting, standing, or even walking. Back pains may grow down to arms or legs and may lead a person to disability.

Your neck and back muscles may strain because of a poor posture – especially when you are in front of a screen. Sometimes the pain gets better with time, but chronic pains may be excruciating. Doctor visits for pain management are common worldwide.

You may relieve the pain with exercise, over-the-counter pain relievers, therapies, or oral medications. However, your doctor may give you a shot to ease your pain and inflammation.

How do Injections Help?

Injecting shots is a non-surgical treatment. Injections may treat your acute or chronic spinal pain, providing relief. Doctors use injections for diagnosis as well as treatment purposes.

The doctors inject the suspected area with numbing drugs, such as anesthesia. If the patient experiences pain relief, it confirms that the specific joint, or part is the pain source.

Compared to oral medications, injections may provide instant relief in your inflammatory or damaged nerve. Injections also help in case of spinal stenosis –narrowing of the spine.

Common Pain Injections

For treating neck and back pains, doctors generally use therapeutic injections. The pain may stem from a facet joint, a spinal nerve, or an intervertebral disc. Here are some common pain reliever injections.

·      Epidural Steroid Injections

The injections contain corticosteroid; a common steroid; and a numbing drug. The shots help to reduce inflammation.

For Back Pain: The doctor injects the medicine in the epidural space – the area around the spinal cord.

For Neck Pain: The doctor injects the shot in the facet joint located in the cervical spine bones or neck muscles.

·      Selective Nerve Block Injections

Selective nerve blocks numb a specific spinal nerve. The doctors mostly inject lidocaine (common anesthesia) around the targeted nerve. The numbness provides instant relief from the pain and lasts for several hours.

·      Medial Branch Nerve Blocks

The physician deposits the medicine around medial spinal nerve branches. Medial branch nerve is responsible for sending pain signals from the arthritic facet joints to the brain. Medial branch nerve blocks can provide instant relief from neck pain. They may also comfort and ease the headaches stemmed from the neck.

·      Discography

Nerve blocking injections also serve as diagnostic injections sometimes. The doctors inject the shots to identify the root cause of back pain. Discography helps the physician to outline the best treatment. He may inject both a steroid and anesthetic drug in the epidural space of your spine or may choose another option.

·      Sacroiliac (SI) joint injections

There are two sacroiliac joints in our lower back on either side of the spine. These joints connect our lower spine and pelvis. A pain may stem from the lower back advancing to the buttock region. The pain triggers when inflammation of SI joint occurs. Sacroiliac joints injections provide relief for several months.

Some of the injections provide instant relief, while some become effective in a week or two. Depending upon the type of shot you have received, you may need to rest. Your doctor may ask you to limit your physical activity. The above mentioned and other injections help to strengthen your muscular system.

Bottom Line

Pain injections can help with acute and chronic Spinal and musculoskeletal pains. With proper pain management, you can prevent surgical intervention. Contact us today and book an appointment with Spine New York City for your spinal treatment.

Matthew Grimm, MD
646-862-5555

Spinal Injections for Back Pain

chronic-back-pain-medical-info-nyc-top-doctor-02Chronic back pain really is, well, a pain! Many people across the world deal with regular, chronic pain in their back. There are plenty of over-the-counter treatment solutions that may help. But in many cases, a spinal injection can be just the right thing to relieve your pain. but what are some of the causes for back pain? What can we do to remediate pain in the meantime? And how do spinal injections help?

Causes of Back Pain

Our back is one of the most frequently used parts of the body. Sitting, standing, leaning, twisting, bending, and lifting all require the key muscles in our back to activate and the specific spinal structures in our back to work properly. Over time, this constant use wears down the cartilaginous discs that cushion the space between our vertebrae. This leads to swelling, redness, and pain. Poor body mechanics and posture can also contribute to back pain. Completing the same tasks over and over, such as lifting boxes for moving or picking up objects off the floor, gradually wears down the structures in the back that are required for stability. Other conditions, including autoimmune disorders, can cause pain in the back in a similar fashion. In the unfortunate scenario of some kind of trauma, such as a car accident or other injury, the structures in the back can be severely affected, putting more pressure on the nervous system and causing pain.

What we can do About Back Pain

spinal-injections-for-back-pain-01Thankfully, there are things you can do right now to deal with your back pain. This includes simple, easy solutions like using ice packs or hot packs around the painful area. Good ergonomic techniques when used during strenuous activity can help prevent further degradation or trauma to the back. Stretching and strengthening the muscles in the back and associated areas can help support the parts of the back that are at risk for further damage. Over-the-counter pain relief medications may help to reduce swelling and pain in the affected areas temporarily. However, it must be noted that anyone these solutions only offer temporary relief. In order to really affect a lasting change, the root cause of the problem must be addressed.

How Spinal Injections can Help

different-parts-spine-for-pain-injections-diagram-03Spinal injections are a proven, beneficial way to reduce pain and swelling in the spine and back. In a spinal injection, a small amount of medication, typically a steroid or pain reliever, is injected into the painful region in the spine. This medication helps both with reducing pain and lowering swelling. For some people, these spinal injections help to relieve pain for years at a time. For others, the effects of these injections only last for a few days. Even when this is the case, the momentary relief can give you a head start on recovering from whatever caused your pain in the first place. For example, if you have a bulging disc in your back and receive a spinal injection for treatment, the swelling may go down to allow for stretching and strengthening of the surrounding area that brings the inflammation to a manageable level. At this point, more conservative treatments can be pursued and a long-term solution can be found.

Do you suffer from chronic back pain? Make an appointment with Dr. Grimm to find out if spinal injections may help you.